Has COVID-19 changed carer's views of health and care integration in care homes? A sentiment difference-in-difference analysis of on-line service reviews.
Has COVID-19 changed carer's views of health and care integration in care homes? A sentiment difference-in-difference analysis of on-line service reviews.
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DOI：
10.1016/j.healthpol.2022.08.010
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发表时间：
2022-11
期刊：
影响因子：
3.3
通讯作者：
Morciano, Marcello
中科院分区：
文献类型：
--
作者：
Almorox, Eduardo Gonzalo;Stokes, Jonathan;Morciano, Marcello
关键词：
卫生与社会保健的更紧密结合是许多国家的政策优先事项。 COVID-19 大流行强化了卫生和社会护理系统联合的必要性，特别是在疗养院环境中。然而，融合对于居民和护理人员体验的意义和重要性尚不清楚，我们也不知道在大流行期间它是否发生了变化。使用来自在线疗养院服务评论的独特数据，我们结合了多种方法。我们使用自然语言处理和监督机器学习来构建疗养院居民及其亲属的情绪衡量标准（通过 AFINN 分数衡量）。通过比较与整合相关的评论（包含特定术语）和没有整合的评论中的情绪变化，使用双重差异分析来检查经历整合护理是否改变了这些情绪。最后，我们使用对后估计结果的网络分析来评估利益相关者在详细描述他们在疗养院中最积极/最不积极的健康和护理一体化经历时最关注哪些特定属性，以及这些属性在大流行期间是否发生了变化。在大流行前时期，包含整合词的评论比与整合无关的评论更积极（AFINN 得分约为 2.3 分），并且在大流行的第一年仍然如此。 COVID-19 期间总体积极情绪有所增加（平均 +1.1 点），主要是在第一波（+2.17，p 值 0.175）和第二波（+3.678，p 值 0.027）开始时提到整合条款的评论中。疗养院工作人员的作用在正面和负面评价中都至关重要，从大流行前的护理相关方面转向大流行期间的信息服务，这表明他们在将基于需求的综合范式转化为政策和实践方面的重要性。
Closer integration of health and social care is a policy priority in many countries. The COVID-19 pandemic has reinforced the necessity of joining up health and social care systems, especially in care home settings. However, the meaning and perceived importance of integration for residents’ and carers’ experience is unclear and we do not know whether it has changed during the pandemic. Using unique data from on-line care home service reviews, we combined multiple methods. We used Natural Language Processing with supervised machine learning to construct a measure of sentiment for care home residents' and their relatives’ (measured by AFINN score). Difference-in-difference analysis was used to examine whether experiencing integrated care altered these sentiments by comparing changes in sentiment in reviews related to integration (containing specific terms) to those which were not. Finally, we used network analysis on post-estimation results to assess which specific attributes stakeholders focus on most when detailing their most/least positive experiences of health and care integration in care homes, and whether these attributes changed over the pandemic. Reviews containing integration words were more positive than reviews unrelated to integration in the pre-pandemic period (about 2.3 points on the AFINN score) and remained so during the first year of the pandemic. Overall positive sentiment increased during the COVID-19 period (average by +1.1 points), mainly in reviews mentioning integration terms at the beginning of the first (+2.17, p-value 0.175) and second waves (+3.678, p-value 0.027). The role of care home staff was pivotal in both positive and negative reviews, with a shift from aspects related to care in pre-pandemic to information services during the pandemic, signalling their importance in translating integrated needs-based paradigms into policy and practice.
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